AIDS and Behavior

, Volume 22, Issue 1, pp 64–76 | Cite as

Determining Preferences Related to HIV Counselling and Testing Services Among High School Learners in KwaZulu-Natal: A Discrete Choice Experiment

  • Michael Strauss
  • Gavin L. George
  • Bruce D. RhodesEmail author
Original Paper


A key strategy of the South African national response to HIV is the scale-up of HIV counselling and testing (HCT) in the 15–49 years age group. The integrated school health policy aims to guide the roll out of youth-friendly health services including the provision of HCT in schools. Using a discrete choice experiment to examine preferences regarding the attributes of HCT service packages, this study identifies barriers to and facilitators of HCT among high school learners. Monetary considerations were found to have the strongest effect of any attribute on choice, whilst confidentiality was found to be a primary concern for learners considering HCT. Policy makers and service providers must ensure that confidentiality is maintained, and could consider using monetary incentives as a way of increasing uptake of HCT. Programmes designed to reduce social stigma and improve education and knowledge dissemination around HCT and HIV, are vital in creating demand for HCT and changing attitudes among young people.


South Africa Discrete choice experiment Adolescents HIV testing 



Assistance from colleagues from the research team at CAPRISA was invaluable for conducting this study. A big thank you goes specifically to the team arranging and coordinating the school visits and liaising with school principals and teachers. The authors also acknowledge the input from colleagues at the Health Economics and HIV and AIDS Research Division whose comments have helped to shape this piece of work, specifically Kaymarlin Govender, one of the primary investigators on the overarching VMMC study. The authors thank the team of fieldworkers and data capturers and translators, without whose assistance this study would not have been possible. The authors also acknowledge the financial support of the Swedish International Development Cooperation Agency (Sida), which helped to finance this research.


Funding for this project was provided by the Heath Economics and AIDS Research Division (HEARD) at the University of KwaZulu-Natal using general funds (no Grant number) supported by the Swedish International Development Agency (SIDA).

Compliance with Ethical Standards

Conflict of interest

Michael Strauss, Gavin George, and Bruce Rhodes declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution. Permission to conduct this study was obtained from the Human and Social Sciences Ethics Committee at the institution. A waiver of parental consent was granted for participants older than 16 but younger than 18 years, given that children in South Africa can access HCT services without parental consent. All participants signed written informed consent forms before enrollment into the study. This article does not contain any studies with animals performed by any of the authors.

Supplementary material

10461_2016_1602_MOESM1_ESM.pdf (3.8 mb)
Supplementary material 1 (PDF 3876 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Michael Strauss
    • 1
  • Gavin L. George
    • 1
  • Bruce D. Rhodes
    • 2
    Email author
  1. 1.Health Economics and HIV and AIDS Research Division (HEARD)University of KwaZulu-NatalDurbanSouth Africa
  2. 2.School of Accounting, Economics and FinanceUniversity of KwaZulu-NatalDurbanSouth Africa

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